Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Runner’s knee1Tensor fascia latae syndrome (TFLS)Iliotibial band friction syndrome (ITBFS) ++ 728.89 Other disorders of muscle, ligament, and fascia ++ M62.89 Other specified disorders of muscle ++ 4D: Impaired joint mobility, motor function, muscle performance, and ROM associated with connective tissue dysfunction2 +++ Description ++ Original presumed model of repetitive stress injury due to friction between the IT band3 and lateral femoral condyle, occurring at approximately 30 degrees of knee flexion4Inflammation begins at IT band’s insertion and where friction develops between the IT band and lateral femoral condyle1Newer proposed model of the ITB being a thickness within the lateral fasciaTightening is a result of repetitive stressLateral extension of the synovial capsule in the knee, lateral synovial recessCyst formationOsseous edema without evidence of fascial inflammationBursitis that develops deep within the IT band as it crosses the lateral femoral condyle3 +++ Essentials of Diagnosis ++ Diagnosis usually made by clinical examinationProgression of symptoms often associated with changes in training practice (e.g., increased running mileage or change in training surfaces, especially downhill running1)Pain from ITBFS so severe that activity must be discontinued +++ General Considerations ++ Most commonly occurs from overuse injury of the knee, especially in long-distance runnersFrequently develops in people with inadequate warm-up or stretching program before exerciseAssociated with leg-length discrepancies, tensor fascia latae contractures, excessive pronation, tight heel cords1, 6Though most common in runners, may occur with any activity requiring constant knee flexion and extension1 +++ Demographics ++ Men and women equally affectedDistance runners, exacerbated with downhill runningCyclistsRepetitive knee flexion, extensionTraining on uneven terrain or graded slopesChange in Q-angle as a result of leg-length discrepancy4 +++ Signs and Symptoms ++ Localized tenderness and pain along lateral aspect of knee, especially with repetitive knee motionPain may be diffuse and general at onset, becoming more specific and intense as ITBFS progressesSpecific pain localized approximately 2 cm above joint line over the lateral femoral condyle with knee flexed 30 degrees3Pain will radiate to lateral joint line and distally to proximal tibia1Pain typically begins after completion of activity, but may occur during activity or periods of rest as condition progresses7Crepitus upon palpation over lateral condyle3Specific swelling over lateral condyle3Increased pain after long periods of sitting4 +++ Functional Implications ++ Pain with running (especially on downhill terrain) and cyclingPain with walking and other activities that elicit knee flexion, especially as the condition persistsPain with sitting for prolonged periods +++ Possible Contributing Causes ++ Biomechanical abnormalitiesLeg-length discrepanciesTensor fasciae ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.